Skip to main content
Top
Published in: Osteoporosis International 8/2007

01-08-2007 | Original Article

Cost-effectiveness of alendronate in the treatment of postmenopausal women in 9 European countries - an economic evaluation based on the fracture intervention trial

Authors: O. Ström, F. Borgström, S. S. Sen, S. Boonen, P. Haentjens, O. Johnell, J. A. Kanis

Published in: Osteoporosis International | Issue 8/2007

Login to get access

Abstract

Summary

Treatment with alendronate (Fosamax®) has been shown to significantly reduce the risk of fragility fractures. Cost-effectiveness of treatment was assessed in nine European countries in a Markov model and was generally found to be cost effective in women with a previous spine fracture.

Introduction

Treatment with alendronate (Fosamax®) reduces the risk of osteoporotic fractures at the spine, hip and wrist in women with and without prevalent vertebral fracture. Cost-effectiveness estimates in one country may not be applicable elsewhere due to differences in fracture risks, costs and drug prices. The aim of this study was to assess the cost-effectiveness of treating postmenopausal women with alendronate in nine European countries, comprising Belgium, Denmark, France, Germany, Italy, Norway, Spain, Sweden, and the UK.

Methods

A Markov model was populated with data for the nine European populations. Effect of treatment was taken from the Fracture Intervention Trial, which recruited women with low BMD alone or with a prior vertebral fracture.

Results

The cost per QALY gained of treating postmenopausal women with prior vertebral fractures ranged in the base case from “cost saving” in the Scandinavian countries to €15,000 in Italy. Corresponding estimates for women without prior vertebral fractures ranged from “cost saving” to €40,000.

Conclusions

In relation to thresholds generally used, the analysis suggests that alendronate is very cost effective in the treatment of women with previous vertebral fracture, and in women without previous vertebral fracture, cost-effectiveness depends on the country setting, discount rates, and chosen monetary thresholds.
Literature
1.
go back to reference Melton LJ 3rd (1993) Hip fractures: a worldwide problem today and tomorrow. Bone 14(Suppl 1):S1–S8PubMedCrossRef Melton LJ 3rd (1993) Hip fractures: a worldwide problem today and tomorrow. Bone 14(Suppl 1):S1–S8PubMedCrossRef
2.
go back to reference Black DM, FIT Research Group et al (2000) Fracture risk reduction with alendronate in women with osteoporosis: the fracture intervention trial. J Clin Endocrinol Metab 85(11):4118–4124PubMedCrossRef Black DM, FIT Research Group et al (2000) Fracture risk reduction with alendronate in women with osteoporosis: the fracture intervention trial. J Clin Endocrinol Metab 85(11):4118–4124PubMedCrossRef
3.
go back to reference Black DM, Fracture Intervention Trial Research Group et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348(9041):1535–1541PubMedCrossRef Black DM, Fracture Intervention Trial Research Group et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348(9041):1535–1541PubMedCrossRef
4.
go back to reference Cummings SR et al (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the fracture intervention trial. Jama 280(24):2077–2082PubMedCrossRef Cummings SR et al (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the fracture intervention trial. Jama 280(24):2077–2082PubMedCrossRef
5.
go back to reference Johnell O et al (2003) Cost-effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21(5):305–314PubMedCrossRef Johnell O et al (2003) Cost-effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures. Pharmacoeconomics 21(5):305–314PubMedCrossRef
6.
go back to reference Borgström F et al (2003) Cost-effectiveness of alendronate for the treatment of postmenopausal women in the UK. submitted Borgström F et al (2003) Cost-effectiveness of alendronate for the treatment of postmenopausal women in the UK. submitted
7.
go back to reference Borgström F et al (2003) Cost-Effectiveness of alnedronate in the treatment of male osteoporosis. Bone. accepted Borgström F et al (2003) Cost-Effectiveness of alnedronate in the treatment of male osteoporosis. Bone. accepted
8.
go back to reference Jonsson L, Borgstrom F, Zethraeus N (2003) [Cost-effectiveness of alendronate treatment of osteoporosis in Denmark. An economic evaluation based on the fracture intervention trial]. Ugeskr Laeger 165(43):4112–4116PubMed Jonsson L, Borgstrom F, Zethraeus N (2003) [Cost-effectiveness of alendronate treatment of osteoporosis in Denmark. An economic evaluation based on the fracture intervention trial]. Ugeskr Laeger 165(43):4112–4116PubMed
9.
go back to reference Rosner AJ et al (1998) Cost-effectiveness of multi-therapy treatment strategies in the prevention of vertebral fractures in postmenopausal women with osteoporosis. Pharmacoeconomics 14(5):559–573PubMedCrossRef Rosner AJ et al (1998) Cost-effectiveness of multi-therapy treatment strategies in the prevention of vertebral fractures in postmenopausal women with osteoporosis. Pharmacoeconomics 14(5):559–573PubMedCrossRef
10.
go back to reference Christensen PM, Brixen K, Kristiansen IS (2003) Danish osteoporosis outcome model (DOOM) Christensen PM, Brixen K, Kristiansen IS (2003) Danish osteoporosis outcome model (DOOM)
11.
go back to reference Borgstrom F, Zethraeus N (2003) [Economic assessment based on a clinical study of risedronate. Fracture prevention in elderly women with osteoporosis is cost-effective]. Lakartidningen 100(1–2):36-40PubMed Borgstrom F, Zethraeus N (2003) [Economic assessment based on a clinical study of risedronate. Fracture prevention in elderly women with osteoporosis is cost-effective]. Lakartidningen 100(1–2):36-40PubMed
13.
go back to reference Stock JL et al (1997) Increments in bone mineral density of the lumbar spine and hip and suppression of bone turnover are maintained after discontinuation of alendronate in postmenopausal women. Am J Med 103(4):291–297PubMedCrossRef Stock JL et al (1997) Increments in bone mineral density of the lumbar spine and hip and suppression of bone turnover are maintained after discontinuation of alendronate in postmenopausal women. Am J Med 103(4):291–297PubMedCrossRef
14.
go back to reference Greenspan SL et al (2002) Significant differential effects of alendronate, estrogen, or combination therapy on the rate of bone loss after discontinuation of treatment of postmenopausal osteoporosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 137(11):875–883PubMed Greenspan SL et al (2002) Significant differential effects of alendronate, estrogen, or combination therapy on the rate of bone loss after discontinuation of treatment of postmenopausal osteoporosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 137(11):875–883PubMed
15.
go back to reference Tonino RP, Phase III Osteoporosis Treatment Study Group et al (2000) Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. J Clin Endocrinol Metab 85(9):3109–3115PubMedCrossRef Tonino RP, Phase III Osteoporosis Treatment Study Group et al (2000) Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. J Clin Endocrinol Metab 85(9):3109–3115PubMedCrossRef
16.
go back to reference Bone HG et al (2004) Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 350(12):1189–1199PubMedCrossRef Bone HG et al (2004) Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 350(12):1189–1199PubMedCrossRef
17.
go back to reference Borgstrom F et al (2006) An economic evaluation of strontium ranelate in the treatment of osteoporosis in a Swedish setting: Based on the results of the SOTI and TROPOS trials. Osteoporos Int 17(12):1781–1793PubMedCrossRef Borgstrom F et al (2006) An economic evaluation of strontium ranelate in the treatment of osteoporosis in a Swedish setting: Based on the results of the SOTI and TROPOS trials. Osteoporos Int 17(12):1781–1793PubMedCrossRef
18.
go back to reference Federaal Ministerie van Sociale Zaken, Volksgezondheid en Leefmilieu. (Belgium) Federaal Ministerie van Sociale Zaken, Volksgezondheid en Leefmilieu. (Belgium)
19.
go back to reference Vestergaard P, Rejnmark L, Mosekilde L (2005) Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 16(2):134–141PubMedCrossRef Vestergaard P, Rejnmark L, Mosekilde L (2005) Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark. Osteoporos Int 16(2):134–141PubMedCrossRef
20.
go back to reference Elffors I et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS Study. Osteoporos Int 4(5):253–263PubMedCrossRef Elffors I et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS Study. Osteoporos Int 4(5):253–263PubMedCrossRef
21.
22.
go back to reference Kanis JA et al (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11(8):669–674PubMedCrossRef Kanis JA et al (2000) Long-term risk of osteoporotic fracture in Malmö. Osteoporos Int 11(8):669–674PubMedCrossRef
23.
go back to reference Singer BR et al (1998) Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg Br 80(2):243–248PubMedCrossRef Singer BR et al (1998) Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg Br 80(2):243–248PubMedCrossRef
24.
go back to reference Brecht JG et al (2003) Pharmacoeconomic analysis of osteoporosis treatment with risedronate. Int J Clin Pharmacol Res 23(4):93–105PubMed Brecht JG et al (2003) Pharmacoeconomic analysis of osteoporosis treatment with risedronate. Int J Clin Pharmacol Res 23(4):93–105PubMed
25.
go back to reference Kanis JA et al (2000) Risk of hip fracture derived from relative risks: an analysis applied to the population of Sweden. Osteoporos Int 11(2):120–127PubMedCrossRef Kanis JA et al (2000) Risk of hip fracture derived from relative risks: an analysis applied to the population of Sweden. Osteoporos Int 11(2):120–127PubMedCrossRef
26.
go back to reference Kanis JA et al (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int 15(11):862–871PubMedCrossRef Kanis JA et al (2004) Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int 15(11):862–871PubMedCrossRef
27.
go back to reference Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Br Med J 312(7041):1254–1259 Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Br Med J 312(7041):1254–1259
28.
go back to reference Looker AC et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8(5):468–489PubMedCrossRef Looker AC et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8(5):468–489PubMedCrossRef
29.
go back to reference Klotzbuecher CM et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739PubMedCrossRef Klotzbuecher CM et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739PubMedCrossRef
30.
go back to reference Kanis JA et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382PubMedCrossRef Kanis JA et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382PubMedCrossRef
31.
go back to reference Felsenberg D et al (2002) Incidence of vertebral fracture in Europe: results from the European prospective osteoporosis study (EPOS). J Bone Miner Res 17(4):716–724CrossRef Felsenberg D et al (2002) Incidence of vertebral fracture in Europe: results from the European prospective osteoporosis study (EPOS). J Bone Miner Res 17(4):716–724CrossRef
32.
go back to reference Report on osteoporosis in the European community-action for prevention. 1998, European Commission-Employment & Social Affairs Report on osteoporosis in the European community-action for prevention. 1998, European Commission-Employment & Social Affairs
33.
34.
go back to reference Life tables, years 1999–2001. Institut National d’Édutes démographiques. 2004 Life tables, years 1999–2001. Institut National d’Édutes démographiques. 2004
35.
go back to reference Johannesson M (1996) Theory and methods of economic evaluation of health care. Dev Health Econ Public Policy 4:1–245PubMed Johannesson M (1996) Theory and methods of economic evaluation of health care. Dev Health Econ Public Policy 4:1–245PubMed
36.
go back to reference Tengs TO, Wallace A (2000) One thousand health-related quality-of-life estimates. Med Care 38(6):583–637PubMedCrossRef Tengs TO, Wallace A (2000) One thousand health-related quality-of-life estimates. Med Care 38(6):583–637PubMedCrossRef
38.
go back to reference Christensen PM et al (2005) Cost-effectiveness of alendronate in the prevention of osteoporotic fractures in Danish women. Basic Clin Pharmacol Toxicol 96(5):387–396PubMedCrossRef Christensen PM et al (2005) Cost-effectiveness of alendronate in the prevention of osteoporotic fractures in Danish women. Basic Clin Pharmacol Toxicol 96(5):387–396PubMedCrossRef
41.
go back to reference Oden A et al (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8(6):599–603PubMedCrossRef Oden A et al (1998) Lifetime risk of hip fractures is underestimated. Osteoporos Int 8(6):599–603PubMedCrossRef
42.
go back to reference Kanis JA et al (2003) The components of excess mortality after hip fracture. Bone 32(5):468–473 Kanis JA et al (2003) The components of excess mortality after hip fracture. Bone 32(5):468–473
43.
go back to reference Parker MJ, Anand JK (1991) What is the true mortality of hip fractures? Public Health 105(6):443–446PubMedCrossRef Parker MJ, Anand JK (1991) What is the true mortality of hip fractures? Public Health 105(6):443–446PubMedCrossRef
44.
go back to reference Kanis J et al (2002) Excess mortality after vertebral fracture. WHO Collabortaing centre for metabolic bone diseases: Sheffield, UK Kanis J et al (2002) Excess mortality after vertebral fracture. WHO Collabortaing centre for metabolic bone diseases: Sheffield, UK
47.
go back to reference Zethraeus N et al (1997) The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 68(1):13–17PubMedCrossRef Zethraeus N et al (1997) The cost of a hip fracture. Estimates for 1,709 patients in Sweden. Acta Orthop Scand 68(1):13–17PubMedCrossRef
48.
go back to reference Zethraeus N et al (2002) Costs and quality of life associated with osteoporosis related fractures-results from a swedish survey. Working Paper Series in Economics and Finance, 512 Zethraeus N et al (2002) Costs and quality of life associated with osteoporosis related fractures-results from a swedish survey. Working Paper Series in Economics and Finance, 512
51.
go back to reference Kanis JA et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427PubMedCrossRef Kanis JA et al (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427PubMedCrossRef
52.
go back to reference Zethraeus N Strom O, Borgstrom F (2006) What is the risk of institutionalization after hip fracture? Poster at ECCEO, Vienna Zethraeus N Strom O, Borgstrom F (2006) What is the risk of institutionalization after hip fracture? Poster at ECCEO, Vienna
53.
go back to reference Jönsson B et al (1996) Cost-effectiveness of fracture prevention in established osteoporosis. Scand J Rheumatol Suppl 103:30–38 Jönsson B et al (1996) Cost-effectiveness of fracture prevention in established osteoporosis. Scand J Rheumatol Suppl 103:30–38
54.
go back to reference Kind P et al (1998) Variations in population health status: results from a United Kingdom national questionnaire survey. Br Med J 316(7133):736–741 Kind P et al (1998) Variations in population health status: results from a United Kingdom national questionnaire survey. Br Med J 316(7133):736–741
55.
go back to reference Lundberg L et al (1999) Health state utilities in a general population in relation to age, gender and socioeconomic factors. Eur J Public Health 9(3):211–217CrossRef Lundberg L et al (1999) Health state utilities in a general population in relation to age, gender and socioeconomic factors. Eur J Public Health 9(3):211–217CrossRef
56.
go back to reference Kanis JA et al (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15(1):20–26PubMedCrossRef Kanis JA et al (2004) The risk and burden of vertebral fractures in Sweden. Osteoporos Int 15(1):20–26PubMedCrossRef
57.
go back to reference Brazier JE, Green C, Kanis JA (2002) A systematic review of health state utility values for osteoporosis-related conditions. Osteoporos Int 13(10):768–776PubMedCrossRef Brazier JE, Green C, Kanis JA (2002) A systematic review of health state utility values for osteoporosis-related conditions. Osteoporos Int 13(10):768–776PubMedCrossRef
58.
go back to reference Raftery J (2001) NICE: faster access to modern treatments? Analysis of guidance on health technologies. Br Med J 323(7324):1300–1303CrossRef Raftery J (2001) NICE: faster access to modern treatments? Analysis of guidance on health technologies. Br Med J 323(7324):1300–1303CrossRef
59.
go back to reference Översyn av samhällsekonomiska metoder och kalkylvärden på transportområdet-ASEK Review of cost benefit calculation. Methods and valuations in the transport sector. SIKA Rapport, 2002. 4 Översyn av samhällsekonomiska metoder och kalkylvärden på transportområdet-ASEK Review of cost benefit calculation. Methods and valuations in the transport sector. SIKA Rapport, 2002. 4
60.
go back to reference Kanis JA, Jönsson B (2002) Economic evaluation of interventions for osteoporosis. Osteoporos Int 13(10):765–767PubMedCrossRef Kanis JA, Jönsson B (2002) Economic evaluation of interventions for osteoporosis. Osteoporos Int 13(10):765–767PubMedCrossRef
61.
go back to reference Macroeconomics and Health: investing in health for economic development. Report of the Commission on Macroeconomics and Health, W.C.o.M.a. Health, Editor. 2001:Geneva Macroeconomics and Health: investing in health for economic development. Report of the Commission on Macroeconomics and Health, W.C.o.M.a. Health, Editor. 2001:Geneva
62.
go back to reference Hart WM et al (2002) Análisis farmacoeconómico del tratamiento de la osteoporosis postmenopáusica con risedronato o alendronato. REEMO 11(3):97–104 Hart WM et al (2002) Análisis farmacoeconómico del tratamiento de la osteoporosis postmenopáusica con risedronato o alendronato. REEMO 11(3):97–104
63.
go back to reference Autier P, Belgian Hip Fracture Study Group et al (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Osteoporos Int 11(5):373–380PubMedCrossRef Autier P, Belgian Hip Fracture Study Group et al (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Osteoporos Int 11(5):373–380PubMedCrossRef
64.
go back to reference Ankjaer-Jensen A, Johnell O (1996) Prevention of osteoporosis: cost-effectiveness of different pharmaceutical treatments. Osteoporos Int 6(4):265–275PubMedCrossRef Ankjaer-Jensen A, Johnell O (1996) Prevention of osteoporosis: cost-effectiveness of different pharmaceutical treatments. Osteoporos Int 6(4):265–275PubMedCrossRef
65.
go back to reference Visentin P, Ciravegna R, Fabris F (1997) Estimating the cost per avoided hip fracture by osteoporosis treatment in Italy. Maturitas 26(3):185–192PubMedCrossRef Visentin P, Ciravegna R, Fabris F (1997) Estimating the cost per avoided hip fracture by osteoporosis treatment in Italy. Maturitas 26(3):185–192PubMedCrossRef
66.
go back to reference Andersen L et al (1995) Cost-effectiveness of alendronate for the prevention of osteoporotic fractures in Norwegian women. Statens Institutt for Folkhelse: Oslo Andersen L et al (1995) Cost-effectiveness of alendronate for the prevention of osteoporotic fractures in Norwegian women. Statens Institutt for Folkhelse: Oslo
67.
go back to reference Dolan P, Torgerson DJ (1998) The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporos Int 8(6):611–617PubMedCrossRef Dolan P, Torgerson DJ (1998) The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporos Int 8(6):611–617PubMedCrossRef
68.
go back to reference Kanis JA (2002) Epidemiology and costs of fractures in the UK: Background document for male osteoporosis model. Personal communication Kanis JA (2002) Epidemiology and costs of fractures in the UK: Background document for male osteoporosis model. Personal communication
69.
go back to reference Zethraeus N et al (2002) Costs and quality of life associated with osteoporosis related fractures-results from a Swedish survey. Working paper series in economics and finance, 512. Stockholm: Stockholm School of Economics Zethraeus N et al (2002) Costs and quality of life associated with osteoporosis related fractures-results from a Swedish survey. Working paper series in economics and finance, 512. Stockholm: Stockholm School of Economics
70.
go back to reference Puffer S et al (2004) Health care costs of women with symptomatic vertebral fractures. Bone 35(2):383–386PubMedCrossRef Puffer S et al (2004) Health care costs of women with symptomatic vertebral fractures. Bone 35(2):383–386PubMedCrossRef
72.
go back to reference 1. Stockholms stads budgetavräkning. Stadsledningskontorets redovisningsstab 2003 [cited] 1. Stockholms stads budgetavräkning. Stadsledningskontorets redovisningsstab 2003 [cited]
75.
go back to reference The danish ministry of health. Takstsystem 2001, 2000. ISBN 1395–2528 The danish ministry of health. Takstsystem 2001, 2000. ISBN 1395–2528
77.
go back to reference EBM 2000 plus. 2004, Kassenärztliche Vereinigung Bayern EBM 2000 plus. 2004, Kassenärztliche Vereinigung Bayern
79.
go back to reference Honorato J et al (2004) Pharmacoeconomic analysis of bemiparin and enoxaparin as prophylaxis for venous thromboembolism in total knee replacement surgery. Pharmacoeconomics 22(13):885–894PubMedCrossRef Honorato J et al (2004) Pharmacoeconomic analysis of bemiparin and enoxaparin as prophylaxis for venous thromboembolism in total knee replacement surgery. Pharmacoeconomics 22(13):885–894PubMedCrossRef
81.
go back to reference Osteoporosis in the European community: A call to action: an audit of policy developments since 1998, in international osteoporosis foundation. 2001 Osteoporosis in the European community: A call to action: an audit of policy developments since 1998, in international osteoporosis foundation. 2001
82.
go back to reference Priser för södra sjukvårdsregionen-Vårdtjänster per klinik. 2003 Universitetssjukhuset i Lund Priser för södra sjukvårdsregionen-Vårdtjänster per klinik. 2003 Universitetssjukhuset i Lund
83.
go back to reference Stevenson M, Jones ML, Nigris Ed. Assessment report: The clinical effectiveness and cost effectiveness of prevention and treatment of osteoporosis, http://www.nice.org. 2004 [cited Stevenson M, Jones ML, Nigris Ed. Assessment report: The clinical effectiveness and cost effectiveness of prevention and treatment of osteoporosis, http://​www.​nice.​org. 2004 [cited
91.
Metadata
Title
Cost-effectiveness of alendronate in the treatment of postmenopausal women in 9 European countries - an economic evaluation based on the fracture intervention trial
Authors
O. Ström
F. Borgström
S. S. Sen
S. Boonen
P. Haentjens
O. Johnell
J. A. Kanis
Publication date
01-08-2007
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 8/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-007-0349-5

Other articles of this Issue 8/2007

Osteoporosis International 8/2007 Go to the issue